CLIA lab
CLIA 45D2167362: Impact Health Direct Primary Care, PLLC
Ennis, TX. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 45D2167362 belongs to Impact Health Direct Primary Care, PLLC in Ennis, TX.
Certificate for Provider-Performed Microscopy Procedures, effective June 6, 2025, expires June 5, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate for Provider-Performed Microscopy Procedures
- Certificate effective
- June 6, 2025
- Certificate expiration
- June 5, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 6, 2019
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 45D2167362
- Lab name
- Impact Health Direct Primary Care, PLLC
- Address
- 711 West Lampasas Street, Attn Kara Sjogren, Ennis, TX 75119
- Phone
- (817) 564-3575
- Fax
- (410) 237-6747
Annual test volume the lab reported
- Waived tests
- 200
- Provider-performed microscopy tests
- 50
- Total
- 250
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Cook Children's Pediatircs - EnnisCertificate of Waiver, Physician office45D2330249
- D Blayne Laws MD PACertificate of Waiver, Physician office45D1031125
- DFW Oral and Maxillofacial Surgery, EnnisCertificate of Waiver, Physician office45D2319613
- DR Fredric Puckett PLLCCertificate for Provider-Performed Microscopy Procedures, Physician office45D2024029
- Davey M Perrin, MDCertificate of Waiver, Physician office45D2283464
- Ellis County Coalition for Health OptionsCertificate of Waiver, Federally qualified health center45D2120454
- Ellis County Medical Associates, PACertificate of Waiver, Physician office45D0478401
Related
Questions
What is the CLIA number for Impact Health Direct Primary Care, PLLC in Ennis?
45D2167362, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Impact Health Direct Primary Care, PLLC hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 45D2167362 expire?
The CMS file lists June 5, 2027 as the certificate expiration date; the certificate took effect June 6, 2025.